Henry Ford Hospital Medical Journal


In a 20-month prospective study, 35 patients with postoperative myocardial infarction were identified. All patients referred to cardiologists by nonthoracic surgeons were evaluated for evidence of postoperative myocardial infarction as defined by symptoms, electrocardiographic changes, and cardiac enzyme elevation. Ten of the 35 patients (29%) subsequently died, seven (20%) from the myocardial infarction. Twenty-five of the 35 patients (71%) had preexisting coronary artery disease. Reported experience with patient mortality following postoperative myocardial infarction varies from 28% to 69%. Our patient mortality rate at 29%, though still substantial, is lower than many current reports. Despite close perioperative surveillance of patients with coronary artery disease, the morbidity and mortality remains unacceptably high. Physicians should routinely evaluate the surgical patient thoroughly for cardiac risk.